ust as we think that the dust has settled from COVID-19, the Asia Pacific (APAC) region is now grappling not only with waves of COVID-19 infections but also a significant rise in flu cases.
The impact of influenza on daily lives and healthcare systems is evident throughout the region. In the Philippines, cases of influenza-like illnesses have increased by 46%. Malaysia is urging older adults to get vaccinated due to a sudden increase in flu cases, which has resulted in a shortage of hospital beds. According to the World Health Organization (WHO), flu levels remain high in Southeast Asian countries including Cambodia, Myanmar, Thailand, and the Philippines. Thailand, in particular, has experienced a fivefold increase in influenza cases in 2023 compared to last year’s monthly average, according to the Thai FDA. Japan has even closed schools due to widespread flu outbreaks. While cases have gradually decreased since surpassing the summer influenza threshold, Hong Kong's Centre for Health Protection continues to remind the public to get vaccinated to prevent overwhelming the healthcare system.
Vulnerable populations, including infants, children, pregnant women, and older adults (those age 60 and above) face the highest risks from infectious diseases. While government-funded immunization programmes often cover the young and underprivileged, many older adults are left to manage their preventive healthcare on their own. In the case of influenza, older adults account for up to 70% and 85% of hospitalizations and mortality, respectively. Aging increases the likelihood of serious complications due to frailty and weakened immune systems, with those with cardiovascular diseases particularly susceptible. This is concerning as older adults make up around 15% of the population in the region.
The current flu outbreak disproportionately affects older adults without government-funded immunization coverage, placing a significant burden on families, caregivers, and healthcare systems, straining government budgets, infrastructure capacity, and family finances. Beyond the financial costs, 10% of older adults hospitalized due to influenza complications experience loss of independence, impacting their quality of life and family members providing caregiving support.
National Vaccine Coverage Crucial
The COVID-19 pandemic highlighted the vulnerability of older adults and the importance of protecting them through vaccination. Preventing vaccine-preventable diseases like influenza is crucial to avoid future health crises and strain on healthcare systems.
Immunization is a critical pillar of healthy aging policies. Evidence demonstrates that vaccinating older adults reduces the health and economic burden on individuals, societies, and the healthcare system, with the 2023 Southern Hemisphere influenza vaccine reducing influenza-associated hospitalizations by 52%.
While certain countries in the region, like Singapore, have made great strides in preventive health measures, more needs to be done across the region to make adult immunization routine. Singapore’s Healthier SG initiative aims to improve citizens' health and quality of life by providing subsidized screenings and vaccinations, including influenza and pneumococcal vaccines.
However, many APAC countries lack recognition of the importance of routine vaccination beyond childhood, leading to low vaccination rates among older adults and vulnerable groups. Influenza vaccine uptake is only 14.9% among the general Asian population and 37.3% among high-risk groups, well below the WHO target rate of 75%. In Singapore, only 32.4% of adults 65 years and older are vaccinated against influenza, and in Malaysia, it is around 5.5% for those over 60. Countries like Malaysia and Thailand lack adult influenza vaccination programs, burdening high-risk groups with immunization costs. Vietnam has limited subsidized immunization services for the elderly, and vaccine accessibility remains a challenge.
Concerted efforts are necessary to better protect our older adults from the flu, including increasing vaccination rates and implementing targeted strategies. Achieving high immunization rates will require purposeful action and collaboration amongst diverse stakeholders across the healthcare ecosystem.
Keys to Successful Immunization Programs
In APAC economies without national immunization programs (NIPs) targeting older adults, the current flu season presents an opportunity to explore differentiated funding mechanisms that provide necessary protection against influenza for vulnerable populations. For example, the Philippines has successfully utilized “Sin Taxes” to purchase and include new vaccines into its NIP.
Even in countries with free vaccine programs through NIPs, awareness about vaccine-preventable diseases remains low, compounded by misinformation and misconceptions about their severity. In the Philippines, where influenza vaccines are provided for free to older adults, only 30% of the population are aware of such programs. In Indonesia, many people underestimate the flu’s health threat and believe they will recover without treatment, leading to a lack of perceived need for vaccination. Singapore faces challenges with vaccine misinformation and low confidence, resulting in low uptake rates.
There are common priorities that could enhance pandemic preparedness and improve seasonal influenza prevention and control. These recommendations in a recent whitepaper by the EU-ASEAN Business Council, supported by Sanofi, prioritize life-course immunization in a post-pandemic era, preparing health systems, healthcare workers, and stakeholders to manage future burdens:
- Increase affordability of vaccinations through free or subsidized vaccines
- Incorporate life-course immunization as part of national immunization policies
- Increase awareness, education and engagement of the public, healthcare providers, community health workers and the media on the value of vaccination
- Improve vaccine procurement, supply chain and logistics
- Develop robust data surveillance systems and infrastructure
To ensure continued access to influenza vaccines for older adults and protect against flu complications, sustainably funded programs and strategies are crucial. Governments can implement differentiated vaccine strategies that prioritize vulnerable populations and leverage high antigen content flu vaccines. Differentiated influenza vaccines offering broader protection, including against pneumonia and heart attacks, have shown improved health outcomes. Influenza vaccination can reduce the risk of flu-triggered heart attacks by up to 45%.
Everyone deserves protection from vaccine-preventable diseases like influenza. Access to the appropriate vaccine should be available to all, regardless of age, ethnicity, socioeconomic status, or healthcare risk factors.
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Lessons from COVID-19 on Influenza Protections for Older Adults
A couple socially distances during the pandemic in the Philippines. Recent surges in the flu and COVID-19 have governments concerned about getting vulnerable populations vaccinated. Image by Iqbal Nuril Anwar from Pixabay
January 5, 2024
Influenza cases are spiking alarmingly in the Asia Pacific, alongside new waves of COVID-19. Affected governments must confront poor funding mechanisms for funding programs and education populations on vaccinations, write Dr. Lulu Bravo and Karine Labaky.
J
ust as we think that the dust has settled from COVID-19, the Asia Pacific (APAC) region is now grappling not only with waves of COVID-19 infections but also a significant rise in flu cases.
The impact of influenza on daily lives and healthcare systems is evident throughout the region. In the Philippines, cases of influenza-like illnesses have increased by 46%. Malaysia is urging older adults to get vaccinated due to a sudden increase in flu cases, which has resulted in a shortage of hospital beds. According to the World Health Organization (WHO), flu levels remain high in Southeast Asian countries including Cambodia, Myanmar, Thailand, and the Philippines. Thailand, in particular, has experienced a fivefold increase in influenza cases in 2023 compared to last year’s monthly average, according to the Thai FDA. Japan has even closed schools due to widespread flu outbreaks. While cases have gradually decreased since surpassing the summer influenza threshold, Hong Kong's Centre for Health Protection continues to remind the public to get vaccinated to prevent overwhelming the healthcare system.
Vulnerable populations, including infants, children, pregnant women, and older adults (those age 60 and above) face the highest risks from infectious diseases. While government-funded immunization programmes often cover the young and underprivileged, many older adults are left to manage their preventive healthcare on their own. In the case of influenza, older adults account for up to 70% and 85% of hospitalizations and mortality, respectively. Aging increases the likelihood of serious complications due to frailty and weakened immune systems, with those with cardiovascular diseases particularly susceptible. This is concerning as older adults make up around 15% of the population in the region.
The current flu outbreak disproportionately affects older adults without government-funded immunization coverage, placing a significant burden on families, caregivers, and healthcare systems, straining government budgets, infrastructure capacity, and family finances. Beyond the financial costs, 10% of older adults hospitalized due to influenza complications experience loss of independence, impacting their quality of life and family members providing caregiving support.
National Vaccine Coverage Crucial
The COVID-19 pandemic highlighted the vulnerability of older adults and the importance of protecting them through vaccination. Preventing vaccine-preventable diseases like influenza is crucial to avoid future health crises and strain on healthcare systems.
Immunization is a critical pillar of healthy aging policies. Evidence demonstrates that vaccinating older adults reduces the health and economic burden on individuals, societies, and the healthcare system, with the 2023 Southern Hemisphere influenza vaccine reducing influenza-associated hospitalizations by 52%.
While certain countries in the region, like Singapore, have made great strides in preventive health measures, more needs to be done across the region to make adult immunization routine. Singapore’s Healthier SG initiative aims to improve citizens' health and quality of life by providing subsidized screenings and vaccinations, including influenza and pneumococcal vaccines.
However, many APAC countries lack recognition of the importance of routine vaccination beyond childhood, leading to low vaccination rates among older adults and vulnerable groups. Influenza vaccine uptake is only 14.9% among the general Asian population and 37.3% among high-risk groups, well below the WHO target rate of 75%. In Singapore, only 32.4% of adults 65 years and older are vaccinated against influenza, and in Malaysia, it is around 5.5% for those over 60. Countries like Malaysia and Thailand lack adult influenza vaccination programs, burdening high-risk groups with immunization costs. Vietnam has limited subsidized immunization services for the elderly, and vaccine accessibility remains a challenge.
Concerted efforts are necessary to better protect our older adults from the flu, including increasing vaccination rates and implementing targeted strategies. Achieving high immunization rates will require purposeful action and collaboration amongst diverse stakeholders across the healthcare ecosystem.
Keys to Successful Immunization Programs
In APAC economies without national immunization programs (NIPs) targeting older adults, the current flu season presents an opportunity to explore differentiated funding mechanisms that provide necessary protection against influenza for vulnerable populations. For example, the Philippines has successfully utilized “Sin Taxes” to purchase and include new vaccines into its NIP.
Even in countries with free vaccine programs through NIPs, awareness about vaccine-preventable diseases remains low, compounded by misinformation and misconceptions about their severity. In the Philippines, where influenza vaccines are provided for free to older adults, only 30% of the population are aware of such programs. In Indonesia, many people underestimate the flu’s health threat and believe they will recover without treatment, leading to a lack of perceived need for vaccination. Singapore faces challenges with vaccine misinformation and low confidence, resulting in low uptake rates.
There are common priorities that could enhance pandemic preparedness and improve seasonal influenza prevention and control. These recommendations in a recent whitepaper by the EU-ASEAN Business Council, supported by Sanofi, prioritize life-course immunization in a post-pandemic era, preparing health systems, healthcare workers, and stakeholders to manage future burdens:
- Increase affordability of vaccinations through free or subsidized vaccines
- Incorporate life-course immunization as part of national immunization policies
- Increase awareness, education and engagement of the public, healthcare providers, community health workers and the media on the value of vaccination
- Improve vaccine procurement, supply chain and logistics
- Develop robust data surveillance systems and infrastructure
To ensure continued access to influenza vaccines for older adults and protect against flu complications, sustainably funded programs and strategies are crucial. Governments can implement differentiated vaccine strategies that prioritize vulnerable populations and leverage high antigen content flu vaccines. Differentiated influenza vaccines offering broader protection, including against pneumonia and heart attacks, have shown improved health outcomes. Influenza vaccination can reduce the risk of flu-triggered heart attacks by up to 45%.
Everyone deserves protection from vaccine-preventable diseases like influenza. Access to the appropriate vaccine should be available to all, regardless of age, ethnicity, socioeconomic status, or healthcare risk factors.
